Description
All data and definitions are based on the Updated Breast Chapter – AJCC Cancer Staging Manual 8th Edition, released on November 10th, 2017 that included the classic Anatomic Stage Group and the new and revolutionary Prognostic Stage Group (divided in Clinical Prognostic Stage and Pathological Prognostic Stage) with the incorporation of biomarker factors that predict more accurately cancer outcome for a more personalized and precise approach.
The prognostic factors included in the new TNM are: Tumor Grade (G), HER2, Estrogen Receptor (ER) and Progesterone Receptor (PR). Genomic Profiles were also incorporated as a prognostic factor for eligible cases (pT1-T2 N0 M0 HER2- and ER+) in the Pathological Prognostic Stage.
The Anatomic Stage is based solely on the anatomic extent of cancer as defined by the T, N, and M categories and should be used for all patients even if prognostic staging is possible.
The Clinical Prognostic Stage will be used to assign stage for all patients based on history, physical examination, imaging studies, and relevant biopsies. Clinical Prognostic Stage is determined by cT, cN, c/pM, G, HER2, ER, and PR. Genomic profile information is not included in Clinical Prognostic Stage.
The Pathological Prognostic Stage will be used to assign stage for patients who have the surgical resection as the initial treatment of their cancer before any systemic or radiation therapy. It includes all information used for clinical staging plus findings at surgery and pathological findings from surgical resection. Pathological Prognostic Stage is determined by pT, pN, c/pM, G, HER2, ER, and PR. Genomic profile information can be used for the Pathological Prognostic Stage (pT1-T2 N0, HER2- and ER+). Pathological Prognostic Stage does not apply to patients treated with chemotherapy, hormone therapy or radiation prior to surgical resection (neoadjuvant therapy).
This App provides the quantification of the category change of the Clinical Prognosis Stage (cPS) and also the Pathological Prognostic Stage (pPS) in relation to the Anatomic Stage (AS) expressed in the Staging Line with the symbol +1, +2, +3 in case of worsening in the Prognostic Staging or -1, -2, -3 in case of improvement in the Prognostic Staging. When no symbol is shown, it is because the AS and cPS or AS and pPS are identical.
This App has other function that shows Oncotype DX® / Genomic Profile field only in some setting when the genomic test is potentially indicated (pT1-T2 N0, HER2- and ER+).
This App is very useful for breast surgeons, surgical oncologists, medical oncologists, radiation oncologists, pathologists, radiologists, medical students, scientists, researchers, and all healthcare professionals working in the field of breast oncology.
© TNM8 Breast Cancer Calculator is copyright of Wesley Andrade.
Used with permission of the American College of Surgeons, Chicago, Illinois. The original source for this information is the AJCC Cancer Staging Manual, Eighth Edition (2017) published by Springer International Publishing.
